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. 2022 Jan 21;22(1):91.
doi: 10.1186/s12885-022-09192-1.

Statin use is associated with the reduction in hepatocellular carcinoma recurrence after liver surgery

Elias Khajeh  1 , Arash Dooghaie Moghadam  1 , Pegah Eslami  1 , Sadeq Ali-Hasan-Al-Saegh  1 , Ali Ramouz  1 , Saeed Shafiei  1 , Omid Ghamarnejad  1 , Sepehr Abbasi Dezfouli  1 , Christian Rupp  2   3 , Christoph Springfeld  3   4 , Carlos Carvalho  5 , Pascal Probst  1 , Seyed Mostafa Mousavizadeh  1 , Arianeb Mehrabi  6   7
Affiliations

Statin use is associated with the reduction in hepatocellular carcinoma recurrence after liver surgery

Elias Khajeh et al. BMC Cancer. .

Abstract

Background: Hepatocellular carcinoma (HCC) is the sixth most common form of cancer worldwide. Although surgical treatments have an acceptable cure rate, tumor recurrence is still a challenging issue. In this meta-analysis, we investigated whether statins prevent HCC recurrence following liver surgery.

Methods: PubMed, Web of Science, EMBASE and Cochrane Central were searched. The Outcome of interest was the HCC recurrence after hepatic surgery. Pooled estimates were represented as hazard ratios (HRs) and odds ratios (ORs) using a random-effects model. Summary effect measures are presented together with their corresponding 95% confidence intervals (CI). The certainty of evidence was evaluated using the Grades of Research, Assessment, Development and Evaluation (GRADE) approach.

Results: The literature search retrieved 1362 studies excluding duplicates. Nine retrospective studies including 44,219 patients (2243 in the statin group and 41,976 in the non-statin group) were included in the qualitative analysis. Patients who received statins had a lower rate of recurrence after liver surgery (HR: 0.53; 95% CI: 0.44-0.63; p < 0.001). Moreover, Statins decreased the recurrence 1 year after surgery (OR: 0.27; 95% CI: 0.16-0.47; P < 0.001), 3 years after surgery (OR: 0.22; 95% CI: 0.15-0.33; P < 0.001), and 5 years after surgery (OR: 0.28; 95% CI: 0.19-0.42; P < 0.001). The certainty of evidence for the outcomes was moderate.

Conclusion: Statins increase the disease-free survival of patients with HCC after liver surgery. These drugs seem to have chemoprevention effects that decrease the probability of HCC recurrence after liver transplantation or liver resection.

Keywords: Hepatocellular carcinoma; Liver resection; Liver transplantation; Meta-analysis; Statins.

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Conflict of interest statement

All authors declare no conflicts of interests.

Figures

Fig. 1
Fig. 1
Flow chart of study
Fig. 2
Fig. 2
Pooled analysis of hazard ratios for recurrence of HCC
Fig. 3
Fig. 3
Forest plot for HCC recurrence 1 year after liver surgery
Fig. 4
Fig. 4
Forest plot for HCC recurrence 3 years after liver surgery
Fig. 5
Fig. 5
Forest plot for HCC recurrence 5 years after liver surgery
See this image and copyright information in PMC

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